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We report two cases of tortuous internal carotid artery, both involving 81-year-old women. Case 1 had an abnormal sensation in the pharynx on swallowing, while case 2 had difficulty and mild pain on swallowing. MRA was useful for diagnosis. A pulsating mass was located in the lateral lymphatic band in case 2. She was advised to undergo a biopsy at another clinic, but this would have carried a risk of bleeding.Previously reported patients with tortuous internal carotid artery have presented with an abnormal sensation in the pharynx, so it is necessary to consider the possibility of tortuous internal carotid artery in elderly patients with this symptom. Tonsillectomy is occasionally performed in elderly patients. There is a possibility of tortuosity of the internal carotid artery, even if a pulsating mass is not seen in the pharynx, and it is important to palpate the palatine tonsil before and during surgery.

We examined how smoking influenced the bacillus detected from acute and chronic sinusitis cases and the pH of nasal discharge.There was no significant difference in the bacillus detected in sinusitis due to the presence of smoking.The pH of nasal discharge temporarily falls during smoking.The decreased pH of nasal discharge may decrease the bacillus growth inhibition of the normal flora.

We reviewed the treatment of 86 patients with peritonsillar abscesses.We examined by m. a. whether the otolaryngological procedure and the antibiotics (cephems, penicillin, other f3-Ractums and clindamycin) used influenced the treatment period.We found that otolaryngological therapy is the best treatment for peritonsillar abscesses, especially incision and drainage. When aspiration is done, it is necessary to administer penicillin.Any intravenous antibiotics are effective for peritonsillar abscess after incision and drainage except for clindamycin alone.It is necessary to avoid clindamycin monotherapy, and to use clindamycin together with penicillin after aspiration.

Postnasal drip is one of the symptoms of chronic sinusitis, and is often refractory. However, sinusitis is not the only cause, and among other conditions, Tornwaldt's disease can also cause postnasal drip.We report a case of Tornwaldt's disease with postnasal drip that was improved by surgery. Cyst opening was sufficient to treat the postnasal drip in this case. However, since there is a risk of cyst relapse, long-term follow-up is necessary.

We analyzed the relationship between postnasal drip and the state of the nasal middle meatus in 394 patients with sinusitis.There was a weak relationship between postnasal drip and the type of paranasal sinuses. Many of the patients with postnasal drip had bilateral contraction and obstruction of the meatus.

We encountered an infant with a peritonsillar abscess due to pharyngeal injury by a chopstick. Careful follow-up of such injuries is necessary in infants with upper respiratory tract infection because pharyngeal injuries can cause peritonsillar abscess, as in our patient. Only conservative treatment was performed for this patient. Computed tomography was useful for the diagnosis in this case.

We examined 944 patients who visited Tokyo Women's Medical University Daini Hospital Department of Otorhinolaryngology who had experienced abnormal sensations of the throat for three months or more, and who were able to be followed. The patients were examined between January 1993 and December 1997.1) There were many cases of non-organic disease among women in their forties.2) Numerous symptoms of mild illness were detected by the symptom classifications of nasal disease and rhinopharyngeal disease.3) Symptoms often affected the cervical spine, the esophagus, and the stomach at deglutition.4) It is insufficient to judge the presence of an organic disease only from the symptoms and the type of the symptoms.5) The pattern of manifestation of symptoms is important for judging the site of involvement.6) Endoscopic inspection is important for judging the presence of an organic disease.7) It is necessary to recommend examination while keeping in mind organic disease, which can be concealed in cases where the cause is thought to be psychological.

We examined 718 epistaxis cases who visited or were hospitalized in the Tokyo Women's Medical University Daini Hospital.1) Many of the epistaxis cases were men, and a relation to arteriosclerosis was strongly suggested.2) A relation to changes in the diastolic pressure was strongly suggested by the number of epistaxis patients with hypertension.3) The bleeding area, excluding the Kiesselbach area, increased with aging.

A total of 122 patients who visited our Hospital with untreated acute sinusitis with pain, were studied.1) Detailed anamnesis could locate the sinus with lesions considered to be the cause of pain.2) Maxillary sinusitis produced pain in the cheek.3) Ethmoid sinusitis often produced ocular pain.

Among the patients whose first visit with nasal complaints to the Tokyo Women's Medical College Daini Hospital occurred between January 1993 and December 1995, cysts were detected by CT in the postoperative paranasal sinuses of 95 patients.These patients were compared to 42 patients without cysts in postoperative paranasal sinuses.1) The presence of nasal discharge and ocular symptoms was of diagnostic value in cases of postoperative paranasal sinus cyst.2) Nasal discharge was related primary to the presence of postoperative paranasal sinus cysts.3) The presence of nasal polyps was not related to postoperative paranasal sinus cysts.4) The presence of nasal polyps alone was of no diagnostic value in detecting postoperative paranasal sinus cyst, with the excepting of cysts located in the maxillary sinus.

Data were collected and analyzed from 348 patients who presented with untreated nasal allergies at the Tokyo Women's Medical College Daini Hospital and the following results were obtaind:1) The most common symptom was nasal obstruction in patients having perennial nasal allergies, and nasal discharge in patients with seasonal allergies.2) Testing for HD mites showed a higher positivity rate in patients with perennial allergies or allergies in the autumn and winter.3) Testing for Japanese cedar pollen showed a higher positivity rate in patients showing allergic symptoms in the spring, spring and summer, or spring and autumn.4) The BAST scores correctly determined whether allergy was seasonal or non-seasonal in 77.1 of patients.5) However, RAST scores could not distinguish winter allergies from any other types of seasonal allergies.6) Despite this, RAST scores determined the type of seasonal allergy correctly in 56.7% of patients after excluding those with winter allergies.7) HD mite, Japanese cedar, and hogweed antigens are useful for determining the type of seasonal allergy.8) Testing with allergens characteristic of summer and winter, but not spring and autumn is indispensable for determining the type of seasonal allergy.